title: Twenty years of endocrinologic treatment in transsexualism: analyzing the role of chromosomal analysis and hormonal profiling in the diagnostic work-up.
abstract: OBJECTIVE
  To demonstrate that adequate pubertal history, physical examination, and a basal hormone profile is sufficient to exclude disorders of sexual development (DSD) in adult transsexuals and that chromosomal analysis could be omitted in cases of unremarkable hormonal profile and pubertal history.
  
  
  METHODS
  Retrospective chart analysis.
  
  
  METHODS
  Endocrine outpatient clinic of a psychiatric research institute.
  
  
  METHODS
  A total of 475 subjects (302 male-to-female transsexuals [MtF], 173 female-to-male transsexuals [FtM]). Data from 323 (192 MtF/131 FtM) were collected for hormonal and pubertal abnormalities. Information regarding chromosomal analysis was available for 270 patients (165 MtF/105 FtM).
  
  
  METHODS
  None.
  
  
  METHODS
  Pubertal abnormalities, menstrual cycle, and hormonal irregularities in relation to chromosomal analysis conducted by karyotype or hair root analysis.
  
  
  RESULTS
  In the MtF group, 5.2% of the patients reported pubertal irregularities and 5.7% hormonal abnormalities, and in the FtM group 3.8% and 19.1%, respectively. Overall chromosomal abnormality in both groups was 1.5% (2.9% in the FtM and 0.6% in the MtF group). The aneuploidies found included one gonosomal aneuploidy (45,X[10]/47,XXX[6]/46,XX[98]), two Robertsonian translocations (45,XXder(14;22)(q10;q10)), and one Klinefelter syndrome (47,XXY) that had already been diagnosed in puberty.
  
  
  CONCLUSIONS
  Our data show a low incidence of chromosomal abnormalities and thus question routine chromosomal analysis at the baseline evaluation of transsexualism, and suggest that it be considered only in cases of abnormal history or hormonal examination.
authors.affiliation: Department of Internal Medicine, Endocrinology, and Clinical Chemistry, Max Planck Institute of Psychiatry, Munich, Germany. Electronic address: mauer@mpipsykl.mpg.de.
authors.forename: Matthias K
authors.initials: MK
authors.lastname: Auer
authors.forename: Johannes
authors.initials: J
authors.lastname: Fuss
authors.forename: Guenter K
authors.initials: GK
authors.lastname: Stalla
authors.forename: Anastasia P
authors.initials: AP
authors.lastname: Athanasoulia
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D002869:Chromosome Aberrations; D002877:Chromosomes, Human; D005260:Female; D005820:Genetic Testing / Q000379:methods*; D006197:Hair / Q000737:chemistry; D006728:Hormones / Q000097:blood*; D006801:Humans; D007621:Karyotyping; D008297:Male; D008597:Menstrual Cycle / Q000235:genetics; D011237:Predictive Value of Tests; D011627:Puberty / Q000235:genetics; D012189:Retrospective Studies; D057829:Gender-Affirming Procedures / Q000379:methods; D013997:Time Factors; D063106:Transgender Persons; D014189:Transsexualism / Q000097:blood / Q000175:diagnosis* / Q000235:genetics / Q000503:physiopathology / Q000628:therapy; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006728:Hormones
keywords: Transsexualism; hormones; karyotype; menstrual cycle; puberty